“I was battling an aggressive cancer”

As told to Shelley Levitt

Cassandra Levine, 57, Baltimore

The cancerous nodule was small, about the size of an M&M, the doctor said—not a peanut M&M but a chocolate one. It was embedded deep in the breast duct, which was why I’d never felt it and why the technician who did the follow-up mammogram had needed to press so hard, and painfully, on my left breast to get a clear image.

Two weeks later, I had a biopsy. When I met with Dr. Dawn Leonard, medical director of the Herman & Walter Samuelson Breast Care Center at Northwest Hospital in Baltimore, I got the diagnosis: poorly differentiated invasive ductal carcinoma. I had an aggressive cancer that was more likely than other types of cancer to return. If I did nothing, I’d probably be dead in 10 years. But since the cancer was so small, my chances of long-term survival were 98 percent whether I had a lumpectomy or a mastectomy, single or double. Dr. Leonard never tried to influence me one way or another.

It was an entirely different experience when I went to get a second opinion from another surgeon. After I told him I was considering having both breasts removed, his response was, “Why would you want to do that? It took you 53 years to get breast cancer in your left breast. It could take another 53 years to get cancer in your other breast.” I thanked him for his time and left.

Deciding on the treatment with Dr. Leonard was easy. I’ve never smoked, I don’t drink alcohol, I work out six days a week for an hour or more. I do everything I can to stay healthy, and
I did not want to risk a recurrence in the noncancerous breast. My “girls” had turned on me—they had to go. Plus, if I chose lumpectomy, I’d probably need 35 rounds of radiation. I wanted to avoid any procedures that are designed to save your life but can do a lot of damage in the process.

Dr. Leonard did the mastectomy, and another doctor performed reconstruction with temporary expanders. The final pathology report said I had what’s called triple-negative cancer, which is more common in African-American women like me. This type does not respond to targeted drugs like tamoxifen or Herceptin, so I needed four rounds of chemotherapy to wipe out any stray cancer cells.

I feel wonderful today. I actually had my C-cup implants changed; they were getting in the way of exercise, so I swapped them for B cups. Twice a year I see my oncologist, who draws blood to see if there are any markers indicating that the cancer is returning. For the first 18 months after the mastectomy, those appointments made me anxious, but now I look forward to them. The news is always good, and it’s exciting to get confirmation that I’m as healthy as I feel.